Cosmetic Surgery Los Angeles

Getting older and the aging of the face is inevitable.

Over the years, skin on the neck and face will become loose and can look saggy.  The jaw line can become soft and form jowls with the excess skin falling to the front of the neck.

A facelift, or rhytidectomy, can help patients improve their looks and sometimes their self-confidence.  Like for all facial procedures, good health and realistic expectations are a prerequisite.

The goal of a facelift is to improve overall facial appearance.  However, facelifts can’t turn back the clock for a patient, and it will not improve fine facial wrinkles.

What a facelift can do is help a patient’s face look its best and give them a more healthy and youthful appearance.  

A facelift is typically performed under general anesthesia.   In some cases, local injections of anesthesia with intravenous sedation can be used.

Rhinoplasty surgery constantly changes!

Dr. Paul Nassif’s fellowship director, J. Regan Thomas, MD, told him something that he never forgets – According to Dr. Thomas, “You haven’t learned anything about rhinoplasty until you’ve performed at least a thousand procedures and followed them for many years.”

This advice from Dr. Thomas is why Dr. Nassif feels that fellowships are so valuable. “Some of the needed experience and potential pitfalls are circumvented by first hand observing and learning the analysis, judgment, techniques, complication management and most importantly, results from a seasoned rhinoplasty surgeon. This is why I super-specialized in rhinoplasty surgery during my fellowship in Facial Plastic & Reconstructive Surgery,” says Dr. Nassif.

Fellowship training catapults you years ahead of many other surgeons that aren’t fortunate to have post-graduate training.

In the past, cosmetic surgeons commonly were taught to aggressively remove cartilage during a rhinoplasty.  Now aggressive cartilage removal is of the past and less is more. Surgeons are removing less cartilage in procedures.  Many are learning cartilage repositioning, camouflage techniques, structural grafting and suturing techniques in most rhinoplasty courses and at national meetings.

“What happened? Why do I need a revision rhinoplasty only 9 to 10 months following my initial surgery?”

“My nose looked great, and then, the nostrils became pinched, and now my nasal passages seem obstructed.”

These are all common questions that our revision rhinoplasty patients have. These patients are not alone. The need for revision surgery can be because of an aggressive initial surgery or scar contracture with the healing process.  

Unfortunately, revision rhinoplasty is not that rare. Nationally, approximately 5 –12 percent of patients that undergo rhinoplasty need a revision of some kind, whether it is major or minor. The need for revisions can occur even with in the hands of the best rhinoplasty surgeons across the country.

Revision rhinoplasty surgery is the most challenging procedure that Facial Plastic & Reconstructive Surgeons perform.

Perfecting surgery with this three-dimensional structure (the nose) takes years to master and continues to improve. We now find that some rhinoplasty maneuvers that were used three years ago could cause disastrous results today.

BrowLift Patient Indications:

• Furrowed lines above the nose
• A heavy brow that affects the looks of the eyes
• A forehead and brow that looks droopy

Procedure Three very small puncture-type incisions are made in the patient’s hairline.  The endoscopic camera has a probe attached that helps to guide the surgeon to weaken muscles that produce frown lines and allow the surgeon to reposition the eyebrows to a higher level.

  Recovery:

• The patient will have to sleep with their head elevated for several days after a browlift surgery to minimize and reduce swelling
• Discomfort after browlift surgery is minimal and can be controlled easily with oral medication.
• Swelling around the eyes and cheeks is inevitable after surgery.  However, the bruising and swelling should begin to lessen in about a week or so
• Surgical staples should be ready to be removed in seven days

  Intended Result:

• A rested, natural and younger looking appearance
• Properly positioned and elevated eyebrows
• The patient’s frown lines are diminished

The eyebrows can play an important role in a person’s appearance. When the brow descends, whether in youth or due to age, it can cause the face and eyes to look tired. 

A heavy furrow brow can be elevated with a browlift, which sometimes eliminates the need for upper eyelid surgery.

Traditionally, a browlift procedure has started with the surgeon making a large incision from ear to ear.  The results with this technique were good, but patients often developed redness, itching, loss of hair and irritation along the incision site.

With the endoscopic browlift technique, the procedure is minimally invasive. The procedure begins with the surgeon making small incisions slightly behind the hairline.

The surgeon then uses a specialized lighting system and camera to perform the surgery. The recovery from an endoscopic browlift is simpler, and patients are able to quickly return to normal activities. Surgical results are very successful and patient satisfaction is very high.

Many patients wonder what their recovery will be like after blepharoplasty surgery and how soon they can go back to work.

After Blepharoplasty surgery, discomfort is minimal and can easily be controlled with oral medication. It is common for the eyelids to become swollen and bruised, but this typically decreases in a few weeks. Sutures are removed from the eye lids seven days after surgery.

We do let our patients know that it is important to avoid any strenuous activity for a least a week after surgery, this will help reduce swelling and increase healing. Patients can start to wear make up about 10 to 14 days after their blepharoplasty procedure.

Most patients return to work about a week or two after surgery.

Aftercare is a concern of many of our patients. To make sure you are well cared for we recommend that our patients spend at least one night in a post operative after care facility after a facelift. 

There are several in the Los Angeles area that we recommend. The on-site nursing care at these facilities will help address any of your needs. Plus, they let you relax and focus on healing.  

An alternative may be to have an overnight nurse at your house.

Every year, it is estimated that half a million people consult with facial plastic surgeons to find out about improving the appearance of their nose seek. Some are unhappy with the nose they were born with, and some with the way aging has changed their nose. For others, breathing may be a problem, or an injury may have distorted the nose. A slight alteration of the nose can greatly improve one’s appearance.

Rhinoplasty (reshaping the nose), could improve one’s looks, self-confidence or health. As with all facial plastic surgery, good health and realistic expectations are prerequisites. The goal of rhinoplasty is to improve the nose aesthetically without creating a surgical look and to create harmony with other facial features.

Additionally, many patients have a chin augmentation in conjunction with rhinoplasty to create a better balance of features. Rhinoplasty is usually performed with local injections of anesthesia with intravenous sedation, or in some cases, under general anesthesia.

The typical post-operative recovery period (the time necessary for bruising and swelling to resolve) after cosmetic eyelid surgery is 14 days. It is important to avoid strenuous activity for the first week after surgery, but one can return to work during this time if desired. Antibiotic eye drops are generally prescribed for several days after surgery, and patients cannot wear contact lenses for approximately two weeks after surgery, as the eyelids may be stiff and sore. Makeup can be worn after 10-14 days, and the resultant fine scars, which follow the natural contour of the eyelid, tend to fade in about two to three months.

In upper eyelid blepharoplasty, a fine incision is made in the pre-existing crease above each eye. A crescent of excess skin and muscle is then removed, as well as all fat (puffiness) that is present. The incisions are then closed with fine stitches, which are removed in one week. In the lower lids, the fatty deposits are typically repositioned (to prevent a hollow look) or removed from the inside of the lid so that no external incision is made. In some instances, when there is excess skin that needs to be removed, a skin pinch is performed with an incision placed under the lashes so as to avoid a conspicuous scar. As with the upper lids, fine stitches are used to close the incision.